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Temporomandibular disorder (TMD) incidences are believed to be related to parafunctional behaviours like teeth clenching. This pilot study aimed to (i) develop an automated clench-detection algorithm, and (ii) apply the algorithm to test for differences in nocturnal clenching in women with and without TMD. Subjects gave informed consent to participate. Adult women were categorised using Diagnostic Criteria for TMD according to presence/absence (+/-) of both TM joint disc placement (DD) and chronic pain (P) into two groups (+DD+P, -DD-P) with 12 subjects each. Surface temporalis electromyography was recorded during oral tasks performed by subjects at two laboratory sessions. The data were used to characterise muscle activity per N of bite force (μV/N) for each subject, develop the clench-detection algorithm and test its accuracy. Ambulatory surface temporalis electromyography was self-recorded by each subject over three nights and analysed using the algorithm and bite force (N) versus muscle activity μV/N calibrations. Bonferroni-adjusted homoscedastic t-tests assessed for significant between-group differences in clenching (P < 0·05). Sensitivity, specificity and accuracy of algorithm-detected laboratory clenches were all ≥96%. During self-recordings 95% of clenches had durations of

To evaluate whether the presence of both prostate atrophy (PA) and chronic prostate inflammation (CPI) in the same biopsy and in the same biopsy core are associated with prostate cancer (PCa) risk and grade in repeat biopsies. Retrospective analyses of 6132 men who were 50–75 years old undergoing 2-year repeat prostate biopsy after a negative baseline biopsy for PCa in the REduction by DUtasteride of prostate Cancer Events (REDUCE) study. PA, CPI and PCa were determined by central pathology. The association of baseline PA and CPI with 2-year repeat biopsy cancer status and grade was evaluated with χ2 test and logistic regression controlling clinicopathological features. PA, CPI and both were detected in 583 (9.5%), 1063 (17.4%) and 3675 (59.9%) baseline biopsies, respectively. Compared with biopsies with neither PA nor CPI, the presence of PA (odds ratio (OR)=0.73, 95% confidence interval (CI)=0.57–0.93), CPI (OR=0.72, 95% CI=0.58–0.88) and both (OR=0.54, 95% CI=0.45–0.64) were associated with lower PCa risk in the 2-year repeat prostate biopsy. Results were similar in multivariable analysis. Among subjects with both PA and CPI, those with both findings in the same core had even lower PCa risk compared with PA and CPI in different cores (univariable OR=0.68, 95% CI=0.51–0.91; multivariable OR=0.73, 95% CI=0.54–0.99). Combination of PA and CPI was associated with lower risk of high-grade PCa. The presence of both PA and CPI in baseline biopsies, especially in the same core, was associated with lower PCa risk and grade. The presence and topographical distribution of PA and CPI may be used in PCa risk stratification.

The reproducibility of electromyographic (EMG) activity in relation to static bite-force from masticatory muscles for a given biting situation is largely unknown. Our aim was to evaluate the reliability of EMG activity in relation to static bite-force in humans. Eighty-four subjects produced five unilateral static bites of different forces at different biting positions on molars and incisors, at two separate sessions, and the surface EMG activities were recorded from temporalis, masseter, and suprahyoid muscles bilaterally. Intraclass correlation coefficients (ICCs) were determined, and an ICC of ≥ 0.60 indicated good reliability of these slopes. The ICCs for jaw-closing muscles during molar biting were: temporalis muscles, ipsilateral 0.58-0.93 and contralateral 0.88-0.91; and masseter muscles, ipsilateral 0.75-0.86 and contralateral 0.69-0.88. The ICCs for jaw-closing muscles during incisor biting were: temporalis muscles, ipsilateral 0.56-0.81 and contralateral 0.34-0.86; and masseter muscles, ipsilateral 0.65-0.78 and contralateral 0.59-0.80. For the suprahyoid muscles the 95% CIs were mostly wide and most included zero. The slopes of the EMG activity vs. bite-force for a given biting situation were reliable for temporalis and masseter muscles. These results support the use of these outcome measurements for the estimation and validation of mechanical models of the masticatory system.

Objectives To evaluate the safety profile and efficacy of α1-adrenergic receptor blockers (A1Bs) currently prescribed for benign prostatic hyperplasia (BPH).

We review the current understanding of superconductivity in the quasi-one-dimensional organic conductors of the Bechgaard and Fabre salt families. We discuss the interplay between superconductivity, antiferromagnetism, and charge-density-wave fluctuations. The connection to recent experimental observations supporting unconventional pairing and the possibility of a triplet–spin order parameter for the superconducting phase is also presented.

Objectives: The NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) was developed to assess symptoms and quality of life in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). We assessed the responsiveness of the NIH-CPSI to change over time and defined thresholds for changes perceptible to patients. Methods: We studied 174 men with CP/CPPS who participated in a placebo-controlled randomized clinical trial. Changes from baseline to six weeks in the NIH-CPSI total score and pain, urinary, and quality of life subscores were compared to a global response assessment (GRA). Effect sizes and Guyatt statistics were calculated to evaluate responsiveness; 95% confidence intervals were produced using bootstrapping. Results: All scores decreased over time with the largest decrease in subjects who reported on the GRA that they were markedly improved. The NIH-CPSI total, pain, and quality of life scores were highly responsive in the improved groups; the urinary score showed minimal responsiveness. There was no evidence of responsiveness among those subjects who worsened on the trial. ROC curves identified a 6-point decline in the NIH-CPSI total score as the optimal threshold to predict treatment response. Conclusions: The NIH-CPSI total score and pain and quality of life subscores are responsive to change over␣time.

OBJECTIVE To report a prospective, multicentre descriptive study designed to determine the prevalence of the diagnosis of prostatitis in male outpatients examined by urologists in Italy, and to further examine the diagnostic evaluation and treatment of patients identified with a clinical diagnosis of prostatitis. PATIENTS AND METHODS Between July 2001 and October 2001, 70 urologists, representing a cross-section of urological centres in Italy, counted and recorded the overall total of men reported in the clinic and that of patients diagnosed with prostatitis over a 5-week period. Data on demographics, previous diagnoses, symptoms, physical examination, laboratory data and therapy instituted were collected. Patients with a diagnosis of prostatitis completed questionnaires on symptom frequency and severity, and quality of life. RESULTS In all, 8503 patients were included in the primary outcome analysis; 1148 were identified with prostatitis (12.8%; mean age 47.1 years, range 16–83) with all age ranges equally represented, and 68% had had their first symptom within the last year. The most common presenting symptoms were severe, bothersome urinary frequency, obstructive voiding symptoms, perineal, suprapubic and penile pain or discomfort. The self-administered questionnaire confirmed that the most frequently reported and most severe symptoms at the time of evaluation were irritative voiding symptoms, perineal and suprapubic pain and discomfort. Over three-quarters of the patients were dissatisfied with their quality of life. While 98% of the patients had a digital rectal examination and expressed prostatic secretion was successfully recovered in 44%

The National Institutes of Health Classification System for prostatitis has now been accepted by the North American and International urology community. This categorization system consists of category I (acute bacterial prostatitis), category II (chronic bacterial prostatitis), category III (chronic prostatitis/chronic pelvic pain syndrome - CP/CPPS) and category IV asymptomatic inflammatory prostatitis. The evaluation of a patient with category I and category II bacterial prostatitis consists of history and physical examination and urine culture for lower urinary tract localization cultures, respectively. The clinical tests for the evaluation of CP/CPPS can be classified as mandatory, recommended and optional. Mandatory evaluations include history and physical examination, urinalysis and urine culture. Recommended evaluations include lower urinary tract localization tests, symptom index, flow rate, residual urine determination and urine cytology. Optional evaluations include semen analysis and culture, urethral swab, urodynamics, cystoscopy, imaging, and prostate specific antigen determination. The physician must individualize a rational diagnostic strategy for each patient. There is no 'gold standard' for the diagnosis and evaluation of patients presenting with prostatitis.

Objectives To re-survey (after 1 year) men identified in 1999 as having perineal and/or ejaculatory pain/discomfort severe enough to suggest a clinical diagnosis of chronic prostatitis (using the National Institutes of Health-Chronic Prostatitis Symptom Index, NIH-CPSI), and to compare them with an age-matched population of men who had no prostatitis-like symptoms in the initial survey, to determine the effect of time on specific symptoms associated with the diagnosis of chronic prostatitis. Subjects and methods A comprehensive questionnaire incorporating the pain and voiding domains of the NIH-CPSI, and data on demographics, medical history, socio-economic status, health-seeking behaviour and a quality of life assessment, was sent to 67 men who had reported prostatitis-like symptoms in the 1999 survey, and to 202 age-matched controls (1 : 3) who reported no prostatitis-like symptoms in the same survey. Results Forty men (60%) with previous prostatitis-like symptoms, i.e. a mean (sd) 1999 NIH-CPSI pain score of 8.8 (0.4), and 119 (59%) of the control population completed and returned the survey. There was no difference in the 1999 demographics (P = 0.82) or NIH-CPSI pain score (P = 0.49) between patients who returned the recent questionnaire and those who could not be located or declined to complete the survey. Fifteen men (38%) identified with prostatitis in 1999 did not report similar symptoms in 2000. The initial mean NIH-CPSI pain score (0–21) for the men who had resolution of their prostatitis-like symptoms was 7.5 (0.6); 1 year later it was 0.73 (0.3). Their mean age was 51.1 (3.9) years and mean duration of symptoms 1.1 (0.3) years. Those with persistent symptoms had an initial NIH-CPSI pain score of 9.6 (0.5); 1 year later it was 8.68 (0.4), at mean age of 51.4 (2.5) years and duration of symptoms 2.2 (0.3) years. Four men (3%) in the control group who had no symptoms in 1999 reported prostatitis-like symptoms in 2000; these men had a mean age of 52.5 (5.9) and NIH-CPSI pain score of 7.0 (0.9). Conclusion About a third of men reporting prostatitis-like symptoms in the general population had resolution of their symptoms (usually those with a shorter duration and less severe symptoms) 1 year later. The severity of symptoms of men with persistent chronic prostatitis remained relatively unchanged over the year.

Objective To determine the information that men diagnosed with early-stage prostate cancer think is necessary to choose their treatment (surgery, radiotherapy or 'watchful waiting'). Patients and methods All men diagnosed with early-stage prostate cancer in a regional urology practice in an 18-month period were surveyed. Respondents considered the treatment decision for a specific hypothetical case and judged whether each of 59 specific information items would be 'necessary' to know to make the treatment decision. Respondents provided basic demographic information (age, education and marital status). Results Of 89 patients, 71 (80%) responded; the mean (SD, range) number of items that individual respondents identified as necessary was 32 (12, 9-58). Each item was considered necessary by 54 (18, 20-93)% of respondents. Of the 59 items, only five were necessary to > or = 80% of respondents; 23 were necessary to > or = 67% of respondents and five were not necessary to > or = 67% of respondents. Patients were divided about the remaining 31 items. There were no strong correlations (none accounted for > 20% of the variance) between the responses and demographic characteristics. Conclusions There appears to be large variation among patients with early-stage prostate cancer in the number of information items deemed necessary to make a treatment decision, and little agreement on the need for most individual items. Demographic characteristics were not useful as predictors of the information needs of each patient. The process of informing patients with early-stage prostate cancer (and their decision aids) needs to be flexible and able to accommodate a wide range of patients' information needs.

A complex spectral decomposition is developed for the survival probability and spectral density of a simple metastable state in an open quantum system. The time interval before exponential decay occurs is shown to be dominated by the short-lived quasibound states of the system. {copyright} {ital 1998} {ital The American Physical Society}

The results of a combined experimental and theoretical study of elastic electron scattering by laser-excited atoms are presented. From these studies, we extracted differential scattering cross sections and parameters for elastic scattering both by coherently prepared Ba atoms and by Ba atoms in an isotropic, incoherent state of the level. This is the first time that results of this type have been reported for elastic scattering by excited atoms. Good agreement was found between the limited experimental results and those obtained from our convergent close-coupling (CCC) theoretical calculations. It was demonstrated that elastic scattering can create alignment with significant probability.

Interstitial cystitis is the most therapeutically frustrating condition of the urinary tract. The vast array of treatments available clearly indicates that none is particularly effective. As the majority of patients fail to experience a significant and prolonged response to standard treatments, new options are frequently being developed. These include the oral administration of cimetidine, the intravesical use of hyaluronic acid and BCG, and total cystectomy with the formation of a continent urinary diversion. Unfortunately, the acceptance of many new treatments is based on incomplete evaluation, and this has resulted in a confusing array of disparate alternatives. Effective and durable treatment will not be available until the nature of the disease is better understood and the mechanisms of action of current therapies are elucidated.

We describe a crossed electron beam‐atomic beam apparatus which utilizes a pulsed electron gun and field free drift tube to obtain time‐of‐flight (TOF) spectra of electrons scattered from atoms and molecules. This apparatus was constructed for the purpose of obtaining inelastic‐to‐elastic differential cross‐section (DCS) ratios in the energy range extending from threshold to several eV above the threshold of the inelastic channel. The TOF approach eliminates the need for complicated calibration procedures required when using conventional electrostatic electron energy‐loss spectroscopy (EELS) at these low energies. The characteristics of the apparatus will be given, along with representative TOF spectra from carbon monoxide. From those spectra we obtained DCS ratios at 90° scattering angle for excitation of the a3Π state of CO, in the impact energy range of 6–15 eV. These ratios were measured with uncertainties as small as ±4%, which represents a substantial improvement over previous measurements in this e...

Medical therapy for relief of symptoms of benign prostatic hyperplasia (BPH) is now a clinical reality. The challenge for urologists treating BPH with medical therapy is how to rationally employ the two proven classes of medications,the alpha blockers and finasteride, in their practice. To accomplish this, we must critically examine the results of multiple important clinical BPH trials published over the last decade and examine the short and long term effect of the various available medical therapies on symptoms, objective progression and consequences of the disease process and whether evidence based indicators will allow us to choose appropriate therapies. It appears that we can rationalize our medical therapy decisions, taking into consideration severity of disease, prostate size (and perhaps PSA) and most importantly, the patients' longterm expectations for treatment outcome. But first physicians must decide for themselves whether to expand their treatment paradigm beyond short term symptom relief to encompass long term durability and even prevention of the consequences of the long term progression of BPH.

We examined the combined effect of fosfomycin and ofloxacin against Pseudomonas aeruginosa in biofilms by using an in vitro experimental system with a modified Robbins device. Sessile cells in a mature or immature biofilm, developed on a silicon disk, were used, and an ATP bioluminescence assay was employed to assess antibacterial effects. A synergistic effect of fosfomycin and ofloxacin was clearly detected when concentrations at which each drug independently produced no detectable decrease in the bioactivity of sessile cells were used. Exposure of the cells in a mature biofilm to fosfomycin at concentrations of one-eighth of the MIC to 10 times the MIC (6.25 to 500 micrograms/ml) and ofloxacin at three or 10 times the MIC (18.75 or 62.5 micrograms/ml) resulted in reduction of the bioactivity to 1.5 to 4.5% after 72 h. Young sessile cells in an immature biofilm were more susceptible to this combination therapy. With a combination of fosfomycin at three times the MIC and ofloxacin at three times the MIC, complete eradication was confirmed by both ATP assay and scanning electron microscopy.

The bacterial biofilm theory which describes bacterial populations in natural and pathogenic ecological systems in terms of a free-floating or 'planktonic' population of bacteria interacting with a more important matrix enclosed 'sessile' population of bacteria associated with or adherent to a surface, may help explain some of the problems linked to our understanding the nature of urinary tract infections. This paper reviews the role of bacterial biofilm formation in catheter-associated infection, prostatitis and struvite (infected stone) calculogenesis stressing, the importance of bacterial biofilms in the pathogenesis, persistence and hence the treatment of urinary tract infection.

The reproducibility of electromyographic (EMG) activity in relation to static bite-force from masticatory muscles for a given biting situation is largely unknown. Our aim was to evaluate the reliability of EMG activity in relation to static bite-force in humans. Eighty-four subjects produced five unilateral static bites of different forces at different biting positions on molars and incisors, at two separate sessions, and the surface EMG activities were recorded from temporalis, masseter, and suprahyoid muscles bilaterally. Intraclass correlation coefficients (ICCs) were determined, and an ICC of ≥ 0.60 indicated good reliability of these slopes. The ICCs for jaw-closing muscles during molar biting were: temporalis muscles, ipsilateral 0.58-0.93 and contralateral 0.88-0.91; and masseter muscles, ipsilateral 0.75-0.86 and contralateral 0.69-0.88. The ICCs for jaw-closing muscles during incisor biting were: temporalis muscles, ipsilateral 0.56-0.81 and contralateral 0.34-0.86; and masseter muscles, ipsilateral 0.65-0.78 and contralateral 0.59-0.80. For the suprahyoid muscles the 95% CIs were mostly wide and most included zero. The slopes of the EMG activity vs. bite-force for a given biting situation were reliable for temporalis and masseter muscles. These results support the use of these outcome measurements for the estimation and validation of mechanical models of the masticatory system.

Struvite (MgNH4PO46H2O) crystals were produced by Proteus mirabilis growth in artificial urine, in the presence and absence of the urease inhibitor, acetohydroxamic acid (AHA). In the absence of AHA, struvite crystals assumed an "X-shaped" or dendritic crystal habit due to rapid growth along their 100 axis. When AHA was present, crystal growth, as monitored by phase contrast light microscopy, was greatly slowed, and the crystals assumed an octahedral crystal habit. Scanning electron microscopy revealed that crystals grown in the presence of AHA were pitted on their surface. This pitting was absent in control samples. While most of this inhibition by AHA was due to lowered urease activity, some crystal growth inhibition occurred in struvite produced in the absence of urease activity through NH4OH titration of artificial urine. We conclude that while AHA is primarily a urease inhibitor, it may also disrupt struvite growth and formation directly through interference with the molecular growth processes on crystal surfaces.

Total cross sections have been measured for electron scattering on Kr, O2 and CO in the 5-300 eV energy range utilizing a linear attenuation technique. The present results are found to be in good agreement with other experimental data for Kr and CO but deviate significantly from some of the previous measurements in the case of O2.

Total cross sections have been measured for electron scattering on CH 4 in the 4–300 eV energy range utilizing a linear attenuation technique. The present results are compared with existing experimental data of other groups in this energy range. Generally, a good agreement with other experimental data is found except with those of Barbarito, Basta and Caliechio and Sueoka and Mori. The total electron scattering cross sections below 10 eV are inconsistent with available integral elastic scattering cross sections. It is suggested that the elastic data are in error and should be remeasured.

Despite major technological improvements in catheter drainage systems, the indwelling Foley catheter remains the most common cause of nosocomial infection in medical practice. By approaching this common complicated urinary tract infection from the perspective of the biofilm strategy bacteria appear to use to overcome obstacles to produce bacteriuria, one appreciates a new understanding of these infections. An adherent biofilm of bacteria in their secretory products ascends the luminal and external surface of the catheter and drainage system from a contaminated drainage spigot or urethral meatus into the bladder. If the intraluminal route of bacterial ascent is delayed by strict sterile closed drainage or addition of internal modifications to the system, the extraluminal or urethral route assumes greater importance in the development of bacteriuria, but takes significantly longer. Bacterial growth within these thick coherent biofilms confers a large measure of relative resistance to antibiotics even though the individual bacterium remains sensitive, thus accounting for the failure of antibiotic therapy. With disruption of the protective mucous layer of the bladder by mechanical irritation, the bacteria colonizing the catheter can adhere to the bladder’s mucosal surface and cause infection. An appreciation of the role of bacterial biofilms in these infections should suggest future directions for research that may ultimately reduce the risk of catheter-associated infection.

Objectives To evaluate the safety profile and efficacy of α1-adrenergic receptor blockers (A1Bs) currently prescribed for benign prostatic hyperplasia (BPH). Data sources A systematic literature search of MEDLINE, the Cochrane Database and the Food and Drug Administration Web site through December 2006 identified double-blinded, prospective, placebo-controlled trials, evaluating agents commercially available by prescription for the symptomatic treatment of BPH. Review methods Data were reviewed by two investigators with the use of a standardised data abstraction form. Studies were evaluated for methodological quality using the Jadad scale. Studies with a score of < 3 were considered of weaker methodology. Results Of 2389 potential citations, 25 were usable for evaluation of safety data, 26 for efficacy. A1B use was associated with a statistically significant increase in the odds of developing a vascular-related event [odds ratio (OR) 2.54; 95% confidence interval (CI): 2.00–3.24; p < 0.0001]. The odds of developing a vascular-related adverse event were: alfuzosin, OR 1.66, 95% CI: 1.17–2.36; terazosin, OR 3.71, 95% CI: 2.48–5.53; doxazosin, OR 3.32, 95% CI: 2.10–5.23 and tamsulosin, OR 1.42, 95% CI: 0.99–2.05. A1Bs increased Qmax by 1.32 ml/min (95% CI: 1.07–1.57) compared with placebo. Difference from placebo in American Urological Association symptom index/International Prostate Symptom Score was −1.92 points (95% CI: −2.71 to −1.14). Conclusions Alfuzosin, terazosin and doxazosin showed a statistically significant increased risk of developing vascular-related events compared with placebo. Tamsulosin showed a numerical increase that was not statistically significant. All agents significantly improved Qmax and symptom signs compared with placebo.

An ecological approach to the pathogenesis of uncomplicated urinary tract infections allows awareness of the continual battle being waged in the vagina, urethra, and bladder between the bacterial invaders and the host defense mechanisms. Despite overwhelming odds, the bacteria must be able to persist, colonize, and finally adhere to these various battlefields on their ascent to the bladder itself. The large number of patients presenting to physician offices with acute simple cystitis attests to the fact that the bacteria occasionally win the battle of the bladder. An understanding of the pathophysiology of this constantly raging battle may help us modify our clinical approach to women with simple uncomplicated urinary tract infections.

Infection-induced urinary stones form as a result of a urinary tract infection by urease-producing bacteria. These stones are not totally crystalline in nature but rather consist of an agglomeration of bacteria, organic matrix, and crystal of struvite (MgNH4PO4· 6H2O). Crystal formation is related to the ability of the bacteria to effect an increase in the urine pH. Another equally important bacterial role lies in their formation of a ‘biofilm’ which later becomes the organic matrix constituent of the stone. Results of the present in vitro study indicate that crystals are formed more readily if produced within the bacterial biofilm than in the surrounding urine. It is proposed that supersaturation, due in part to a bacterial-induced pH increase and in part to the metal binding tendency of the biofilm, leads to crystal formation via a gel growth mechanism within the biofilm itself. In time further bacterial cell division, microcolony.

Le syndrome douloureux pelvien chez l’homme incluant les prostatites touche approximativement 10 % des hommes et est responsable d’une morbidite et d’un cout medical eleve. Moins de 10 % de ces patients souffrent d’une prostatite bacterienne aigue ou chronique, pathologie qui est bien definie par des parametres cliniques et microbiologiques et habituellement guerie par le traitement antibiotique. La prostatite aigue est caracterisee par une infection systemique severe et des troubles irritatifs urinaires; elle repond rapidement aux traitements antibiotiques. La prostatite bacterienne chronique peut etre ou non associee a un syndrome douloureux pelvien et a des poussees de cystite aigue. Un traitement antibiotique prolonge traite environ 80 % des patients.

Chronic prostatitis has been a perplexing problem for urologists for decades. This review explores the perils and pitfalls urologists encounter with epidemiology, etiology, classification, diagnosis, and treatment of this syndrome. The major question involves the problem of developing rational treatment plans for patients with a medical condition associated with genitourinary pain, variable voiding, and sexual dysfunction but no obvious and accepted etiology. Exciting, innovative, ongoing research does offer some solutions and management strategies that urologists can even now incorporate into their practice while waiting for the fundamental questions to be answered.

The NIH Chronic Prostatitis Symptom Index (CPSI) is recommended in the clinical evaluation of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, its use is not possible in French speakers, as it has not been validated in this population. We performed a linguistic validation of the CPSI.Linguistic translation followed the forward-backward-forward technique and relied on professional medical translators, bilingual health professionals, and patient input. Along with the SF-12, the translated version was administered to a convenience sample of men presenting for pre-vasectomy visits (controls) and to consecutive patients with established CP/CPPS (cases). Men with CP/CPPS were subsequently asked to complete a 14-day retest questionnaire. Psychometric testing addressed standard reliability and validity characteristics.Thirty-six cases and 38 controls with respective mean ages of 46.5 and 44.0 years participated and 33 (91.2%) cases completed the retest questionnaire. Pain (p0.001), urinary (p0.001) and quality-of-life (QOL) scale (p0.001) score means differed between cases and controls. For the same scales, Cronbach's alphas for cases were respectively 0.70, 0.72 and 0.79 versus 0.80, 0.57, and 0.88 for controls. The retest product-moments were 0.83 for pain, 0.55 for urinary, and 0.83 for QOL scales. In cases, strong correlation was noted between QOL and pain scales (r=0.7), and between urinary and pain scales (r=0.6), versus moderate correlation between QOL and urinary scales (r=0.4). Negative correlation was recorded between CPSI scales and SF-12 scales, which ranged from -0.2 to -0.4.When applied to CPPS and control subjects, the French Canadian CPSI translation demonstrates excellent discriminant properties. Moreover, its reliability and validity characteristics confirm the qualities of the CPSI as a standard evaluative tool for men with CPPS.

Using a renormalization group approach, we determine the phase diagram of an extended quasi-one-dimensional electron gas model that includes interchain hopping, nesting deviations and both intrachain and interchain repulsive interactions. d-wave superconductivity, which dominates over the spin-density-wave (SDW) phase at large nesting deviations, becomes unstable to the benefit of a triplet $f$-wave phase for a weak repulsive interchain backscattering term $g_1^\perp>0$, despite the persistence of dominant SDW correlations in the normal state. Antiferromagnetism becomes unstable against the formation of a charge-density-wave state when $g_1^\perp$ exceeds some critical value. While these features persist when both Umklapp processes and interchain forward scattering ($g_2^\perp$) are taken into account, the effect of $g_2^\perp$ alone is found to frustrate nearest-neighbor interchain $d$- and $f$-wave pairing and instead favor next-nearest-neighbor interchain singlet or triplet pairing. We argue that the close proximity of SDW and charge-density-wave phases, singlet d-wave and triplet $f$-wave superconducting phases in the theoretical phase diagram provides a possible explanation for recent puzzling experimental findings in the Bechgaard salts, including the coexistence of SDW and charge-density-wave phases and the possibility of a triplet pairing in the superconducting phase., 19 pages, 13 figures

Using a renormalization group approach, we determine the phase diagram of an extended quasi-one-dimensional electron gas model that includes interchain hopping, nesting deviations and both intrachain and interchain repulsive interactions. We find a close proximity of spin-density- and charge-density-wave phases, singlet d-wave and triplet f-wave superconducting phases. There is a striking correspondence between our results and recent puzzling experimental findings in the Bechgaard salts, including the coexistence of spin-density-wave and charge-density-wave phases and the possibility of a triplet pairing in the superconducting phase., 4 pages, 5 eps figures

We calculate the phase diagram of a ladder system, with a Hubbard interaction and an interchain coupling $t_\perp$. We use a Renormalization Group method, in a one loop expansion, introducing an original method to include $k_{||}$ dependence of couplings. We also classify the order parameters corresponding to ladder instabilities. We obtain different results, depending on whether we include $k_{||}$ dependence or not. When we do so, we observe a region with large antiferromagnetic fluctuations, in the vicinity of small $t_\perp$, followed by a superconducting region with a simultaneous divergence of the Spin Density Waves channel. We also investigate the effect of a non local backward interchain scattering : we observe, on one hand, the suppression of singlet superconductivity and of Spin Density Waves, and, on the other hand, the increase of Charge Density Waves and, for some values of $t_\perp$, of triplet superconductivity. Our results eventually show that $k_{||}$ is an influential variable in the Renormalization Group flow, for this kind of systems., Comment: 20 pages, 19 figures, accepted in Phys. Rev. B 71 v. 24

To determine if finasteride can reduce symptoms in men with a clinical diagnosis of chronic nonbacterial prostatitis (National Institutes of Health, NIH, category IIIA chronic pelvic pain syndrome, CPPS) compared with placebo.Men (76) with category IIIA CPPS enrolled in four North American prostatitis research centres were randomized after a 2-week placebo run-in to finasteride or placebo for 6 months. The primary efficacy variable was a subjective overall assessment (SOA); the secondary efficacy variables included the NIH chronic prostatitis symptom index (NIH-CPSI) and safety data. Patients were assessed at screening, baseline (after the 2-week placebo run-in), 3 and 6 months.Sixty-four patients had at least one assessment on medication (31 placebo, 33 finasteride); 75% of the finasteride and 54% of the placebo group had at least a mild improvement (defined as25% improvement in SOA), and 44% and 27%, respectively, a moderate or marked improvement (50% improvement in SOA). The trend was similar in the NIH-CPSI scores. Five patients in the finasteride and seven in the placebo group reported medication-related adverse events.This randomized placebo-controlled pilot study suggests that finasteride was of benefit for some men with category IIIA CPPS, but the results do not justify recommending finasteride as monotherapy, except for men who also have benign prostatic hyperplasia. A larger, properly powered study, possibly evaluating combination with other therapies or specifically in men with prostatitis and benign prostatic hyperplasia, is required to confirm any clinical benefit.

OBJECTIVES: To determine the questions that treating Ontario urologists think should be addressed with patients who have curable prostate cancer before treatment decisions are made. METHODS: All Ontario (Canada) urologists (179) were given a scenario describing a case of curable prostate cancer and asked to judge the importance, using one of four categories (essential/important/no opinion/avoid), of addressing each of 78 questions. RESULTS: Ninety-seven (54%) of urologists completed the survey. The questions identified most frequently as "essential" to address were: treatment-related incontinence rates (76%), cure rates (74%), treatment-related impotence rates (73%), right of refusal (71%), and mortality from watchful waiting (63%). The questions identified most frequently to "avoid" related to searching for the first medical centre (29%) and the number of prostate cancer patients cured by the physicians (16%). There was little agreement among the urologists on the importance of addressing most of the remaining questions (Average agreement 40.7%). CONCLUSIONS: Most urologists assign great importance to addressing questions related to major treatment morbidity and success rates. Beyond these few major categories, there is widespread disparity among urologists about what information the patient should know. This "information gap" presents an identifiable dilemma in our adherence to the ethical principles underpinning informed consent in patients with potentially curable prostate cancer.

Acute pyelonephritis should be classified clinically at the time of presentation into either uncomplicated or complicated categories. The diagnostic workup includes history, physical examination, urinalysis (including a Gram stain), and urine culture. Patients with suspected complicated pyelonephritis require the standard assessment plus blood cultures and urinary tract imaging, preferably a computed tomography (CT) scan. Patients with moderate, uncomplicated pyelonephritis can be managed as outpatients with either a fluoroquinolone (7-14 days) or trimethoprim/sulfamethoxazole (at least 14 days). Patients with severe, uncomplicated pyelonephritis can be considered for short-term hospitalization and initial administration of intravenous antibiotics. Therapy for patients with complicated pyelonephritis should include initial hospitalization, supportive therapies, administration of wide spectrum intravenous antibiotic therapy, and relief of aggravating conditions. Such maneuvers could consist of simple bladder catheterization, percutaneous nephrostomy drainage, or definitive surgery. Patients with complicated pyelonephritis require longer duration of culture-specific antibiotic dosing, careful monitoring, long-term follow-up, and possible definitive management of their underlying condition.

The purpose of this study was to characterize the tensile stress-strain behavior of the porcine temporomandibular joint (TMJ) disk with respect to collagen orientation and strain rate dependency. The apparent elastic modulus, ultimate tensile strength, and strain at maximum stress were measured at three elongation rates (0.5, 50, and 500 mm/min) for dumbbell-shaped samples oriented along either anteroposterior or mediolateral axes of the disks. In order to study the effects of impact-induced fissuring on the mechanical behavior, the same properties were measured along each orientation at an elongation rate of 500 mm/min for disks subjected to impulsive loads of 0.5 N. s. The results suggested a strongly orthotropic nature to the healthy pristine disk. The values for the apparent modulus and ultimate strength were 10-fold higher along the anteroposterior axis (por = 0.01), which represented the primary orientation of the collagen fibers. Strain rate dependency was evident for loading along the anteroposterior axis but not along the mediolateral axis. No significant differences in any property were noted between pristine and impulsively loaded disks for either orientation (p0.05). The results demonstrated the importance of choosing an orthotropic model for the TMJ disk to conduct finite element modeling, to develop failure criteria, and to construct tissue-engineered replacements. Impact-induced fissuring requires further study to determine if the TMJ disk is orthotropic with respect to fatigue.

To determine the information that men diagnosed with early-stage prostate cancer think is necessary to choose their treatment (surgery, radiotherapy or 'watchful waiting').All men diagnosed with early-stage prostate cancer in a regional urology practice in an 18-month period were surveyed. Respondents considered the treatment decision for a specific hypothetical case and judged whether each of 59 specific information items would be 'necessary' to know to make the treatment decision. Respondents provided basic demographic information (age, education and marital status).Of 89 patients, 71 (80%) responded; the mean (SD, range) number of items that individual respondents identified as necessary was 32 (12, 9-58). Each item was considered necessary by 54 (18, 20-93)% of respondents. Of the 59 items, only five were necessary toor = 80% of respondents; 23 were necessary toor = 67% of respondents and five were not necessary toor = 67% of respondents. Patients were divided about the remaining 31 items. There were no strong correlations (none accounted for20% of the variance) between the responses and demographic characteristics.There appears to be large variation among patients with early-stage prostate cancer in the number of information items deemed necessary to make a treatment decision, and little agreement on the need for most individual items. Demographic characteristics were not useful as predictors of the information needs of each patient. The process of informing patients with early-stage prostate cancer (and their decision aids) needs to be flexible and able to accommodate a wide range of patients' information needs.

We evaluated prostate volume and prostate-specific antigen (PSA) as predictors of acute urinary retention (AUR) in men with benign prostatic enlargement (BPE).Data were pooled from 3 identical 2-year, multinational, multicenter, non-US, placebo-controlled finasteride trials in 4,222 men with BPE and no evidence of prostate cancer.The 2-year incidence of spontaneous AUR was higher in placebo patients with enlarged prostates (4.2% in men with prostate volumeor =40 ml vs. 1.6% in the40 ml group) and higher PSA levels (3.9% in men with PSAor =1.4 ng/ml vs. 0.5% in the1.4 ng/ml group) at baseline. Finasteride reduced AUR incidence by 61% in men with larger prostates, by 63% in men with higher PSA levels, and by 47% in men with smaller prostates, compared with placebo.BPE patients with larger prostate volumes, higher PSA levels and no evidence of prostate cancer have an increased risk of developing AUR and therefore derive the greatest benefit from the risk reduction seen with finasteride therapy.

An experimental model in rats was developed to investigate the significance of mucosal integrity in abacterial prostatitis.Ethanol was instilled into the ventral prostates of male rats to reduce mucosal integrity; dinitrobenzenesulfonic acid (DNBS) was added as an irritant to induce inflammation. Controls received no treatment, ethanol only, DNBS only, or a suspension of bacteria. After various time points, rats were sacrificed, and their prostates were assayed for gross morphology, histological appearance, and cytokine levels.Prostates subjected to ethanol plus DNBS showed significant inflammation, most notably after 12, 24, and 48 hr. Inflammation judged by gross and histological observations and interleukin-1beta levels correlated well at these times. Rats given only ethanol, DNBS, or no treatment, acting as negative controls, displayed little or no inflammation; rats given a bacterial suspension, acting as positive controls, showed inflammation consistent with past studies. Cytokine assays revealed raised interleukin-1beta levels in this model, while tumor necrosis factor-alpha remained at a basal level.The loss of an intact mucosal surface in the prostate resulted in inflammation caused by an irritant. Interleukin-1beta appears to play a role in this inflammation, while tumor necrosis factor-alpha does not.

Mucosal immunity was established in the rat prostate by stimulating the common mucosal system through serosal exposure of formalin-killed Escherichia coli. Immunized but not sham-immunized rats developed bacterial specific IgG and IgA in prostatic fluid, and IgA in urine. Immunized (n = 21) and sham-immunized control rats (n = 30) were challenged by transurethral injection of E. coli into the prostate ducts. Mortality, gross and microscopic pathology, tissue bacterial counts, bacterial associated immunoglobulins, and antibody titers in serum and urine were assessed at 7 days following the challenge. Increased E. coli specific immunoglobulin titers were seen in immunized rats, and E. coli, but not Proteus, found in the prostates of immunized animals were coated with IgG and IgA. Immunization protected against toxaemia and septicemia, seen as a rare complication of acute prostatitis, but did not protect against acute prostatitis, nor alter the degree of tissue damage seen in the rat model.

To determine the extent, pattern and clinical significance of asymptomatic histological inflammation and latent infection (National Institute of Health Category IV prostatitis) in benign prostatic hyperplasia (BPH).The study included 80 patients (from a cohort of 100 consecutive potentially eligible subjects) with a diagnosis of BPH, but no history or symptoms of prostatitis. Histological sections were obtained from specimens collected prospectively at transurethral resection of the prostate (TURP), immunostained for leukocyte common antigen and scanned using a computerized image-analysis system. Foci of inflammation were categorized as glandular, periglandular, stromal or peri-urethral, and the inflammatory cell density graded from 1 to 3. Relationships and correlations were calculated between the volume, degree and type of inflammation, presence and type of bacteria (culture of deep prostatic biopsies), the use of catheters and prostate specific antigen (PSA) levels.Inflammation was identified in all patients but the mean tissue surface area involved was only 1.1% of the total specimen, with periglandular inflammation being the predominant pattern (0.5%). Of the prostate specimens, 44% showed bacterial growth (in 67% of the catheterized patients and 28% of those uncatheterized; 42% of patients were catheterized before TURP). There was no significant difference between any combination of inflammation pattern, volume or grade of inflammation in those catheterized or not (P=0.15) or culture-positive (pathogenic or not) and culture-negative cases (P=0.06). Neither total PSA or PSA density was significantly correlated (P0.05) with the amount, degree or distribution of inflammation.Prostatic inflammation is an extremely common histological finding in patients with symptoms of BPH who have no symptoms of prostatitis. There was no correlation between the degree and pattern of inflammation, catheterization, presence of bacteria, serum PSA or PSA density. The clinical significance of asymptomatic Category IV chronic prostatitis associated with BPH has yet to be determined.